US Tenancy SAMPLE Consent Packet Client Version.pdf
DISCLOSURE REGARDING
BACKGROUND INVESTIGATION ON YOU
________________ (“the Company”) may obtain “consumer reports” about you from a consumer reporting agency for tenant screening purposes. A “consumer report” is a background screening report that may contain information regarding your social security number and identification documents, criminal history, sex offender registry status, credit history, employment history, education history, driving history, professional licenses, drug testing results and other information about you. It may bear upon your character, general reputation, personal characteristics, and/or mode of living.
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NOTICE REGARDING
INVESTIGATIVE CONSUMER REPORTS
____________________ (“the Company”) may also request an “investigative consumer report” on you from a consumer reporting agency.
An “investigative consumer report” is a background screening report generated through personal interviews with sources such as your neighbors, friends or associates.
The consumer reporting agency that may prepare an “investigative consumer report” on you for the Company is Certn (USA) Inc., 3820 Central Avenue #220, Cheyenne, WY 82001, 844-987-0690. The information contained in an “investigative consumer report” may bear upon your character, general reputation, personal characteristics, and/or mode of living.
Please be advised that the nature and scope of the most common form of investigative consumer report that may be ordered by the Company is an investigation into your tenant/rental history. During such an investigation, Certn may ask questions about your tenant/rental history to certain knowledgeable individuals and provide response information to the Company.
Note: You have the right to request additional information regarding the nature and scope of any “investigative consumer report” ordered by the Company on you. You may do so by contacting the Company.
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ADDITIONAL STATE LAW NOTICES
If you live in or are seeking to rent property from __________________ (“the Company”) in Washington State, Massachusetts, New Jersey, New York, or California, please note the following information which we are required by state law to provide to you:
| State of Washington applicants/residents only: If the Company requests an investigative consumer report (as defined by state law) from a consumer reporting agency, you have the right to receive a complete and accurate disclosure of the nature and scope of the investigation requested by the Company. You also have the right to request a written summary of your rights and remedies under the Washington Fair Credit Reporting Act. |
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| Massachusetts applicants/residents only: If the Company requests an investigative consumer report (as defined by state law) from a consumer reporting agency, you have the right to have a copy of the report upon request. |
| New Jersey applicants/residents only: If the Company requests an investigative consumer report (as defined by state law) from a consumer reporting agency, you have the right to have a copy of the report upon request. |
| New York applicants/residents only: You have the right, upon written request, to be informed of whether or not an investigative consumer report (as defined by state law) was requested from a consumer reporting agency. If a report was requested, you will be provided with the name and address of the consumer reporting agency to whom the request was made. You may also inspect and receive a copy of the report by contacting Certn (USA) Inc., 3820 Central Avenue #220, Cheyenne, WY 82001, 844-987-0690. |
| California applicants/residents only: In addition to this document, you are separately receiving a copy of the NOTICE REGARDING BACKGROUND INVESTIGATION PURSUANT TO CALIFORNIA LAW. |
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NOTICE REGARDING BACKGROUND INVESTIGATION
PURSUANT TO CALIFORNIA LAW
_______________________ (“the Company”) intends to obtain information about you from an investigative consumer reporting agency and a consumer credit reporting agency for tenant screening purposes. Thus, you can expect to be the subject of “investigative consumer reports” and “consumer credit reports” obtained for tenant screening purposes.
Investigative consumer reports about you will be prepared by an investigative consumer reporting agency (“ICRA”) named Certn (USA) Inc., 3820 Central Avenue #220, Cheyenne, WY 82001, 844-987-0690. They may include information regarding your social security number and identification documents, criminal history, sex offender registry status, credit history, employment history, education history, driving history, professional licenses, drug testing results and other information about you. They may also include comments from individuals who are knowledgeable about your tenant/rental history or other information about you. Consumer credit reports about you will be prepared by a consumer credit reporting agency (“CCRA”) named Certn (USA) Inc., 3820 Central Avenue #220, Cheyenne, WY 82001, 844-987-0690. They may include information regarding your credit score, payment history, credit history, and other information about you.
The reports obtained by the Company may include information about your character, general reputation, personal characteristics, and mode of living and may be used as a factor in making tenant-related decisions.
Under California Civil Code section 1786.22, you are entitled to find out from an ICRA what is in the ICRA’s file on you with proper identification, as follows:
▪ In person, by visual inspection of your file during normal business hours and upon reasonable notice. You also may request a copy of the information in person. The ICRA may not charge you more than the actual copying costs for providing you with a copy of your file.
By requesting a copy be sent to a specified addressee by certified mail. ICRAs complying with requests for certified mailings shall not be liable for disclosures to third parties caused by mishandling of mail after such mailings leave the ICRAs.
▪ A summary of all information contained in the ICRA’s file on you (which is required to be provided by the California Civil Code) will be provided to you via telephone, if you have made a written request for telephone disclosure and the toll charge, if any, for the telephone call is prepaid by or charged directly to you.
“Proper Identification” includes documents such as a valid driver’s license, social security account number, military identification card, and credit cards. Only if you cannot identify yourself with such information may the ICRA require additional information concerning your employment and personal or family history in order to verify your identity.
The ICRA will provide trained personnel to explain any information furnished to you and will provide a written explanation of any coded information contained in files maintained on you. This written explanation will be provided whenever a file is provided to you for visual inspection.
You may be accompanied by one other person of your choosing, who must furnish reasonable identification. An ICRA may require you to furnish a written statement granting permission to the ICRA to discuss your file in such person’s presence.
Please check this box if you would like to receive a free copy of any investigative consumer report (as defined by relevant state law) obtained by the Company. •
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A Summary of Your Rights Under the Fair Credit Reporting Act
The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under FCRA. For more information, including information about additional rights, go to www.consumerfinance.gov/learnmore or write to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.
• You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment – or to take another adverse action against you – must tell you, and must give you the name, address, and phone number of the agency that provided the information.
• You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your “file disclosure”). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:
- a person has taken adverse action against you because of information in your credit report;
- you are the victim of identity theft and place a fraud alert in your file;
- your file contains inaccurate information as a result of fraud;
- you are on public assistance;
- you are unemployed but expect to apply for employment within 60 days.
In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.consumerfinance.gov/learnmore for additional information.
• You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender.
• You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures.
• Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete, or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.
• Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.
• Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need – usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access.
• You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.consumerfinance.gov/learnmore.
• You may limit “prescreened” offers of credit and insurance you get based on information in your credit report. Unsolicited “prescreened” offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address form the lists these offers are based on. You may opt out with the nationwide credit bureaus at 1-888-5-OPTOUT (1-888-567-8688).
• The following FCRA right applies with respect to nationwide consumer reporting agencies:
CONSUMERS HAVE THE RIGHT TO OBTAIN A SECURITY FREEZE
You have a right to place a “security freeze” on your credit report, which will prohibit a consumer reporting agency from releasing information in your credit report without your express authorization. The security freeze is designed to prevent credit, loans, and services from being approved in your name without your consent. However, you should be aware that using a security freeze to take control over who gets access to the personal and financial information in your credit report may delay, interfere with, or prohibit the timely approval of any subsequent request or application you make regarding a new loan, credit, mortgage, or any other account involving the extension of credit.
As an alternative to a security freeze, you have the right to place an initial or extended fraud alert on your credit file at no cost. An initial fraud alert is a 1-year alert that is placed on a consumer’s credit file. Upon seeing a fraud alert display on a consumer’s credit file, a business is required to take steps to verify the consumer’s identity before extending new credit. If you are a victim of identity theft, you are entitled to an extended fraud alert, which is a fraud alert lasting 7 years.
A security freeze does not apply to a person or entity, or its affiliates, or collection agencies acting on behalf of the person or entity, with which you have an existing account that requests information in your credit report for the purposes of reviewing or collecting the account. Reviewing the account includes activities related to account maintenance, monitoring, credit line increases, and account upgrades and enhancements.
• You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.
• Identity theft victims and active duty military personnel have additional rights. For more information, visit www.consumerfinance.gov/learnmore.
States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General. For information about your federal rights, contact:
| TYPE OF BUSINESS: | CONTACT: |
|---|---|
| 1.a. Banks, savings associations, and credit unions with total assets of over $10 billion and their affiliates | a. Consumer Financial Protection Bureau 1700 G Street,N.W. Washington,DC20552 |
| b. Such affiliates that are not banks,savings associations,or credit unions also should list,in addition to the CFPB: | b. Federal Trade CommissionConsumer Response Center600 Pennsylvania Avenue,N.W.Washington,DC20580(877)382-4357 |
| 2.To the extent not included in item 1 above:a.National banks,federal savings associations,and federal branches and federal agencies of foreign banks | a. Office of the Comptroller of the CurrencyCustomer Assistance Group1301 McKinney Street,Suite 3450Houston,TX77010-9050 |
| b.State member banks,branches and agencies of foreign banks(other than federal branches,federal agencies,and Insured State Branches of Foreign Banks),commercial lending companies owned or controlled by foreign banks,and organizations operating under section 25 or 25A of the Federal Reserve Act. | b.Federal Reserve Consumer Help CenterP.O.Box1200Minneapolis,MN55480 |
| c.Nonmember Insured Banks,Insured State Branches of Foreign Banks,and insured state savings associations | c.FDIC Consumer Response Center1100 Walnut Street,Box#11Kansas City,MO64106 |
| d.Federal Credit Unions | d.National Credit Union AdministrationOffice of Consumer Financial Protection (OCFP)Division of Consumer Compliance Policy and Outreach1775 Duke StreetAlexandria,VA22314 |
| 3.Air carriers | Asst.General Counsel for Aviation Enforcement&ProceedingsAviation Consumer Protection DivisionDepartment of Transportation1200 New Jersey Avenue,S.E.Washington,DC20590 |
| 4.Creditors Subject to the Surface Transportation Board | Office of Proceedings,Surface Transportation BoardDepartment of Transportation395 E Street,S.W.Washington,DC20423 |
| 5.Creditors Subject to the Packers and Stockyards Act,1921 | Nearest Packers and Stockyards Administration area supervisor |
| 6.Small Business Investment Companies | Associate Deputy Administrator for Capital AccessUnited States Small Business Administration409 Third Street,S.W.,Suite 8200Washington,DC20416 |
| 7.Brokers and Dealers | Securities and Exchange Commission100 F Street,N.E.Washington,DC20549 |
| 8.Federal Land Banks,Federal Land Bank Associations,Federal Intermediate Credit Banks,and Production Credit Associations | Farm Credit Administration1501 Farm Credit DriveMcLean,VA22102-5090 |
| 9.Retailers,Finance Companies,and All Other Creditors Not Listed Above | Federal Trade CommissionConsumer Response Center600 Pennsylvania Avenue,N.W.Washington,DC20580(877)382-4357 |
ACKNOWLEDGMENT AND AUTHORIZATION REGARDING BACKGROUND INVESTIGATION
By signing below, I acknowledge receipt of the following separate documents (and certify that I have read and understood them):
● DISCLOSURE REGARDING BACKGROUND INVESTIGATION ON YOU;
● A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT;
● NOTICE REGARDING INVESTIGATIVE CONSUMER REPORTS; and
● ADDITIONAL STATE LAW NOTICES;
By signing below, I also authorize ____________________ (“the Company”) to obtain “consumer reports” and “investigative consumer reports” about me for tenant screening purposes.
By signing below, I also authorize law enforcement agencies, learning institutions (including public and private schools, colleges and universities), information service bureaus, credit bureaus, data repositories, courts (federal, state and local), motor vehicle records agencies, my past or present employers, the military, and other public or private individuals and institutions to furnish any and all information on me that is requested by Certn, the consumer reporting agency preparing reports about me for ______________________. The information that can be disclosed to Certn includes, but is not limited to, criminal history, sex offender registry status, credit history, employment history, education history, driving history, and information regarding my professional licenses, social security number, identification documents, and drug testing results.
Signature:
Date:
My printed Name: ____________________________________________________________________
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PERSONAL INFORMATION NEEDED FOR BACKGROUND CHECK
Please supply the following information to facilitate a background check on you.
Full Name (First, middle, last): _____________________________________________________
Social Security Number: _______________________
Date of Birth: ________________________
Driver License No.: _________________________________
State Issued: _________________________
Full Current Address
Additional Previous Address Within the Last 7 Years
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